De Abhishek, Sarkar Sumantra, Sharma Nidhi, Ansari Asad, Reja Abu Hena Hasanoor, Sarda Aarti
Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India.
Department of Pediatrics, IPGMER, Kolkata, West Bengal, India.
Indian J Dermatol. 2017 Sep-Oct;62(5):519-523. doi: 10.4103/ijd.IJD_55_17.
One 2-year-old undernourished girl presented to our outpatient with large erythematous scaly plaques in arm along with multiple bony swellings over nose, fingers, left foot, and back for the past 1 year. Apart from skin and bone lesions the girl was also had intermittent fever, pallor, irritability, and malnourishment. Her parents gave a history of incomplete healing at the BCG vaccination site. The case was diagnosed to be case of disseminated mycobacterial infection skin and bone with the help of histopathology, radiological examination, and DNA polymerase chain reaction (PCR). DNA PCR from the skin lesion came positive for mycobacteria tuberculosis complex. The girl was treated with 6 months of standard antitubercular drug treatment with very good improvement not only of her cutaneous and bone changes but also of her general health and growth. We report the case because paucity of similar infection in literature and for greater recognition of potential epidemiological threat.
一名2岁营养不良女童因手臂出现大片红斑鳞屑性斑块，且在过去1年中鼻子、手指、左脚和背部出现多处骨质肿胀，前来我院门诊就诊。除皮肤和骨骼病变外，该女童还伴有间歇性发热、面色苍白、易怒和营养不良。其父母称卡介苗接种部位愈合不全。借助组织病理学、放射学检查和DNA聚合酶链反应（PCR），该病例被诊断为皮肤和骨骼播散性分枝杆菌感染。皮肤病变的DNA PCR检测显示结核分枝杆菌复合群呈阳性。该女童接受了6个月的标准抗结核药物治疗，不仅皮肤和骨骼变化有了显著改善，其总体健康状况和生长发育也有了很大改善。我们报告该病例是因为文献中此类感染较少，且为了提高对潜在流行病学威胁的认识。
